Case presentation
A 73-year-old woman presented with six-month history of progressively worsening exertional shortness of breath. The patient had previously undergone coronary artery bypass grafting (CABG) two years ago for symptomatic, severe, left-sided coronary artery disease using left internal mammary artery (LIMA) graft to left anterior descending (LAD) artery, left radial artery to obtuse marginal branch of circumflex artery and left cephalic vein graft to diagonal branch of LAD artery with good symptomatic relief. The choice of conduits at the initial operation had been dictated by a history of deep vein thrombosis (DVT) and varicose

Case 1
A 49-year-old woman with an unremarkable past medical history presented to her local hospital with irregular palpitations and two syncopal episodes. On both occasions she had regained consciousness without any neurological features, neither as prodrome nor in recovery. Examination revealed a diastolic murmur. Electrocardiogram (ECG) and chest X-ray were normal.
A transthoracic echocardiogram (TTE) revealed a 2–3 cm mass in a non-dilated left atrium. Her transoesophageal echocardiogram showed the mass to be located close to the right, lower pulmonary vein but suggested the point of attachment to be the posterior wall rather than the a

As well as continuing the amazing level of care given to patients @RBandH on the paediatric ward every week, the Vocal Beats team @rbharts charitably funded to bring the arts to patients, staff and local community- will also be regularly visiting patients @royalmarsdenNHS Thanks!